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tv   In Good Shape - Discussing a Diagnosis  Deutsche Welle  September 6, 2018 6:30pm-7:00pm CEST

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what remains of those things to the. seeds of civil rights. peace movement women's. plan to disappear. into the sixty's look look good. this week don't. even. look. welcome to in good shape here's what's coming up. how cleaning agents can damage your health. why fluoride in toothpaste to protect your teeth. and the importance of communication between doctor and patient. and here's your host dr coston leg hello you are in good shape oh i love it when i can bring you good news this makes
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my life as a doctor very enjoyable but life's not always just about the good news the bad news as well and how to break bad news to patients this is what i'm going to talk about this doc does the who lead who is in the college just and the gynecologist here at the burden sorry to. me. and him. and her. and. the doctors patient colony carry the most relevant druck and medicine. while being a med student really learn a lot about the body about diseases but we don't hear an awful lot about how to talk to the patients and this can have a dramatic consequences. like wrong diagnosis. ten years ago british
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laze husband brought to the emergency room speech was slurred and she was showing signs of paralysis he thought it might be a stroke. but instead of a clear discussion on her condition some serious misunderstandings that rose more new for all my wife's speech was slurred and a bit unclear. the doctor said to her. you're an american aren't you which she denied. the doctors eventually reached the conclusion that british airways condition was all in her mind she started to panic. because they kept saying forget all the stroke stuff there's nothing wrong she felt they were treating her like a hypochondriac and. later she suffered a series of strokes so regional symptoms were more than likely not psychosomatic.
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if you wanna just knows just how difficult such cases can be his opinion is frequently sought in disputes about contentious diagnoses he says using clear simple language that patients can understand can prevent a lot of misunderstandings but. the dialogue between patient and doctor is the decisive element in our work with patients when you've come to a conclusion and can adequately explain something to yourself you can usually also explain it to a patient in simple terms but if you can't explain it properly to yourself things can get quite difficult at times. it sounds easy but putting that advice into practice depends on how willing a doctor is to pursue it. and yet more than anything else most patients say they want doctors to communicate better that's the results of a survey conducted by a germ. specially. all the fun with whole
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generations of doctors simply never learned about the importance of communication because medical school is having on science many practitioners especially in the older generation of doctors simply are not aware that discussing a diagnosis with the patient is also a therapeutic activity and it can be a very influential one. martina son was born twelve weeks too early for a long time she feared for his life but it eighteen months she figured the worst was over until a mishandled routine checkup with a specialist. to mention first. shortly before the end of the appointment the developmental neurologist offhandedly asked me if i had already applied for a caroline's and a disabled id. does what i did i felt as
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if the ground beneath me had opened up and that was the first time in those eighteen months of. the doctor told me. that her son would probably never will and even if he did he would need to work or his entire life the words burned into her mind to this day. i could have simply said i'll stick him in the corner and i won't push him. after all what's the point of going to physio therapy three times a week and doing all the exercises at home if you won't walk anyway. why didn't the doctors say you can do this back then that kind of encouragement and motivation would have meant an awful lot to martina. medical psychologist in my research is how strongly the positive influence of medical communication she's discovered talk has an impact and it. measurable this
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could truly study ended there are great studies showing that the mere ritual of treating a patient with your edible al syndrome can improve that patient's condition and relieve pain it's like a placebo effect for a living and if doctors were especially empathetic and were more intensively involved with their patients that improvements were even greater. up to man patient doctor interactions always involve two fundamental prerequisites sufficient time and trust. things that patients like martina and her son play a part or british and her husband karl-heinz would desperately have wished for but didn't always get. and he was there to see who he is the director of the clinic of going to college in the charity in berlin hello thanks for having me today you've written a book on the subject this here is the german version it's called the art of breaking bad news in a good way and the english version is following some time i guess so. what is the
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book for patients or for doctors if i decided to write a book about odds breaking bad news and even about how to do it in the very good way. i notice that every message will touch everybody in the room as a doctor or the suppression of the surreal or to so i decided to write this book for everybody in the room so what is the main advice you can give a doctor for this difficult situation try your best to be prepared give or give the patient space to fly in his own orientation we know if you deliberate the message such as you have killed. that the patient needs only eighteen seconds in the medium to have an own reaction the doctor can not
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accept a silence lower than sixteen seconds because he's not trained and he always socialized to give a message give recommendations so the patient needs eighteen seconds the doctor gives the patient sixteen seconds that leaves a gap of two seconds and those two seconds are important crucial because if the patient can house his own or intake can even to break his own paralyzes then that's a good step to move in the in the purity call but even the physical way can patients also prepare getting it receiving bad news my recommendation is if you go to a doctor if you're going for screeding you go in for prevention you go in for a diagnosis of symptoms and if it's really important that you have somebody in your
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room. wherever then take the pay the friends with you to the employed with a doctor because of this possible and think about who can help me of the situation for a second if i'm prepared for the biopsy for instance to see the result remind yourself what resources can help you keep your strategy if your confidence to overcome the spread messages because in general it's not the only and not the first bet messages so think about it what was previously if i lost my job if i lost my relative or whatever so think about it and maybe it will help you even in this time . and what's the best trust the person you could bring is that always a spouse ask yourself and are ask yourself which person the best to celebrate things and who are the best patient or
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person and. where kim helf bat situations to overcome them. we just talked about cancer and it's always been the diagnosis of cancer but many people survive cancer very afraid that the cancer may be back and sometimes they would need psychological help. a diagnosis of cancer can leave you feeling unspeakably vulnerable and anxious seized by the fear of pain and. the. last knows that all too well when she had a mammogram doctors discovered a lump. the new buick they did a biopsy and found abnormal cells the diagnosis was breast cancer that threatens and you know i think you open all the things they are to have to get through
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surgery chemotherapy and radiotherapy but after the tumor was gone and the treatment completed the fear returned unexpectedly and with a vengeance. this woman did it i'd be out walking my dog and would suddenly burst into tears well i'd been feeling fine and then i was crying and i asked myself what was that about does he have cancer treatments have improved dramatically in the last few years survival rates have been rising for many types of the disease but many patients are still playing by fears that it might come back to the tumor is removed the patient goes home and that's when the problem began. for the patients the key question is what now. we know have good data from the literature that shows how important the emotional aspects are feeling good is actually important for long term survival that was something we underestimated for
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a long time and even. doctors and psychologists have studied the fear of recurrence among cancer survivors if the fear is enduring and intense it can actually. make them sick they're told so it's made me off the cuff in the shinjuku done if i'm always thinking about possible threats and this case a recurrence of then that's a source of chronic stress so it's comparable to an enduring external source of stress such as living in a dangerous place say aleppo this is queer you never know if you'll still be alive the following day this is and it's the same for cancer patients it's the sword of damocles is always hanging over their heads isn't about to drop and that means a raised level of stress. the experience of fear goes hand in hand with events in the brain which send signals throughout the body telling the into renal plans to secrete stress hormones. the heart starts to rain and pound.
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out a last sought treatment for her crippling anxiety cycle oncology deals with just this complex of issues when it is fear rational and realistic and when is it too much who is asking the things like relaxation exercises or distractions only work short term things that the fear keeps coming back you need to take a closer look and consider what it really means for you don what am i really frightened of thought what is the worst case scenario is the kind that actually. it's good to bring fear to the surface learn to observe it and see it for what it is suffield. feelings can erupt suddenly and they can be overwhelming but we can all reflect on our feelings evaluate and analyze them and usually control them or keep them in check. the outer has developed
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a strategy for dealing with her fear physical exercise helps keep it at bay the cancer survivor does a routine called the five tibetans she says it's good. for her body and her mind. is the cloud of course the fear is always there but i no longer call it that i build up my defenses to ward it off. she also spends her time doing things she enjoys being out and has discovered a passion for telling stories especially fairy tales where protagonists often have to overcome terrible obstacles and fears but for the most part in the end they live happily ever after. you know we can all spread our wings you treat some of your patients for quite a long time so how do you do you with them to help to reduce angsty of recurrence what is really important is tried to touch the fear so fear again
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what's so is that that you are afraid to die lonely or that a topic of pain so invites the patients to talk of both of them to think what can help you to do this i've got a viewer question mary smith from ohio writes my best friend was diagnosed with an aggressive two word in her lung two weeks ago you know she's falling into despair what can i do to help her in the beginning to fear first last year so you're like to do this because that's a hard job. and then your best friend do you want that i help you and what i want to tell you still love you to spite the bat to seize the moment and do you like that i help you to cook to make to help you to organize to reform
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militaries do you want that i and scorch you with the doctor's appointments do you want that i be close to you and don't go to overload do this do this go in there take this drug take there's plenty in your book you've write that everybody has individual energy. so what you mean bad thing about what helps me that's maybe my social environment or with my relatives who are my friends but maybe it's even my dog or music or lyrics so think about what can help me to go even in day a little with my own so will and without my inner with my hearts and use this same resources to overcome no this bad but such as. let's talk a little bit about truth if a doctor has to break some bad news it's sometimes easier to lie telling must be
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true or that's a basic and trust it's the cornerstone of air all the relationship so how do you want to fight and to accept chemotherapy with side effects was nourse your p.c. or based on the lie you've got a very personal and i think a very nice ritual you enter day by breaking some good news if i started to read the book and notice that medicine for gods two of the adequate awareness for positive things i collected every day the messages make a plus of the minus and the media will. tell positive messages and maybe three better that searchers. in the ten methods you were really ignored by myself. so i changed my awareness for positive messages for the patient to celebrate go celebrate the positive message for instance there's no killed today you are still
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the life you're doing wonderful things with your family your travel tomorrow or great you go to the doctor they take blood from you one liter and they only talk with you about things what normal that's crazy because we are source allies negative so that's what's reason why i started this book and even. tried to increase the awareness that we have positive that we have to ask you correlate and two unknowns to thank you so much i mean what a wonderful day we should all do and i've got a brilliant message for you if you've got any questions to experts be sure to write me. on an upcoming show we'll be talking about pregnancy what can you do to raise your chances of giving birth to a healthy child which prenatal tests are useful send your questions to in good shape at d w dot com right pregnancy in the subject line we look forward to hearing
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from you. are you afraid of fluoride into paste not me because i always read and spit it out but on the other hand fluoride in toothpaste is a miracle because it's hard to teeth at the fights cavities. there's certainly no shortage of toothpaste promising protection against to stick a and many all of them contained fluoride that margaret doesn't i've heard you shouldn't use it because it's bad for you. it's a question of dosage and anyway i don't swallow and it went out and my father was a doctor and we were given fluorine i use it every now and again and i don't want to get to you know toxicologist edmund mazur's says. fluoride fears are often based on a misunderstanding to swerve fluorine is a very aggressive poisonous gas but it only becomes liquid at minus one hundred
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eighty degrees celsius but fluorine gas has nothing to do with fluoride fluoride as it's negatively charged ions which combines with sodium to yield a relatively harmless salt of a. few other substances have been analyzed as closely as the fluoride that goes into toothpaste and the results of the armed doubt. fluoride is the key to success and preventing tooth decay sense fluoride was introduced on a wide scale in the form of toothpaste tooth decay is beating a retreat worldwide that it is all about biochemistry fluoride collects in the dental enamel and reinforces it which in turn makes the animal more resistant. lawrence effects a well known bacteria in your mouth breaks down sugars and complex hydrocarbons in food producing acid as a byproduct the acid dissolves the calcium and phosphorus into thin amel leaving gaps in the surface that harmful bacteria can enter to cause decay.
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fluoride helps to reintegrate those elements into the animal making it surface smooth and resistant again. and we have not published a study yet that shows tooth decay receiving due to other ingredients in toothpaste only fluoride has there's a fact we haven't seen any studies yet which contradict that. this language for research into fluoride efficacy has been going on for decades only a few years ago the renowned crain collaboration n.g.'s in five hundred seventy one clinical studies and reaffirmed the substances benefits. in the form and dosage we employ it and against tooth decay florida save. and that's been proven in countless scientific studies. took sick and i just edmund mousers says that someone weighing sixty kilograms would have to eat twenty chooks of toothpaste to reach the
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threshold of toxicity. for months if you are used to paste correctly and a normal fashion you can brush your teeth two or three times a day without worrying at all there can't be any negative effects. just how well fluoride protects against his decay has been apparent in dental practices for decades the fifty year olds had dench's back in the one nine hundred sixty s. and seventy's anymore. order can be. biased but nowadays we can say that as long as you take good care of your teeth we can bridge the promise year that you'll still have them at eighty. you look good with them be able to chew with them and they'll be functioning properly and. good dental hygiene at home and at the dentists using fluorite all the science says that's the best way to protect against tooth decay well into old age. earth.
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cleanliness is nice it's a nice side and it's also good for your health but you can't overdo it so be aware you're spotless there. can also harm your skin and your lungs especially of all those chemicals come out of a spray bottle. a brace of bath cleaners some bleach for the toilet and something special for the lime scaling on the tiles a lot of people think the cleaner the better. but popular cleansing agents contain a variety of chemical ingredients some are so corrosive they can only be used with gloves and face masks a lot of people have ended up with skin or respiratory problem. in their home but even so very few use some kind of protection.
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specializes in a work related lung aliments she also gives expert opinions on people who've spent their lives cleaning and become chronically ill as a result. cleaning agents can cause serious problems and susceptible. puts me when you spray a cleansing agency produces very fine droplets which can be inhaled. the mucus membranes in the bronx and can chemically damage those membranes. lungs are the only vulnerable organs a lot of people start to notice changes in the skin on their hands like their names mine. i had to quite a while especially since i've had my own household and have had to clean and wash more myself but my hands get chapped they bleed if i don't use hand cream and it's very painful. detergents attack the look and film that forms the skins natural
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protective layer without that protection the skin is vulnerable to the antibacterial chemicals in a cleaner so those kind of harsh household cleaning agents can't differentiate between bacteria and human skin cells it's inevitable that if i use cleaning agents every day all eventually develop skin problems. avoiding lung or skin damage means above all using less and damp cloth or a quick squirt of gentle so it's often enough. and don't ever mix cleaning agents or use too much of them and when you're cleaning always make sure there's plenty of ventilation. that's it for today you can find more information about health and fitness of facebook page see you again next week and until then let's try to stay. in good shape. let's get some ice cream.
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move. on. from. the.
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mubarak. more intrigue international talk show for journalists to discuss the topic of the week a series of angry sometimes violent demonstrations by far right protesters has prompted soul searching here in germany how should politicians and civil society respond can germany defeat its demons that's the topic on foot we've got china. thirty minutes.
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spent doris greene the moment arrives. to join during a tank on her journey back to freedom. in our interactive documentary. tour of the ring in ten returns home on d w dot com tang's. lehman brothers ten years on a story of ambition. mania. control the rate. of investment bankers who call for terrorist cells will never stop of a system that spun out of control. over. the crash the investment bank lehman brothers start september thirteenth on on g.w. . panama
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plans to release. this is utopian years live from berlin a landmark ruling for the dear rates in india. the tab. the supreme court strikes down a nineteenth century law there criminalized gay sex bringing new hope that india's l g b t communities can live and love without fear we speak to one of the lawyers in the case also on the show sounding the alarm the new york times publishes an article by a senior member of the administration who talks.


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